Treatment Outcome Prospective Study

Various forms of psychotherapy are regarded as effective interventions in mild to moderate depression, but studies comparing the economics of psychotherapy and pharmacotherapy are few (Rosenbaum and Hylan, 1999). One study found that the total health-care costs for patients who received psychotherapy were no different from those for patients who received an antidepressant. However, no efficacy measure was used (Edgell and Hylan, 1997). A randomized, prospective study which evaluated the treatment of depression with nortriptyline, interpersonal therapy or treatment as usual, with outcomes expressed in quality-adjusted life years, found that nortriptyline but not interpersonal therapy was a cost-effective alternative to treatment as usual (Lave et al, 1998). 

Comorbid anxiety and depressive features are common in clinical practice, and DSM-IV has included mixed anxiety-depression in its appendix of conditions needing nosological refinement. The presence of comorbid anxiety has prognostic implications. For example, prospective studies of patients with depression have found that the co-occurrence of panic attacks was correlated with a poor outcome (Coryell et al. 1988 van Valkenburg et al. 1984). Some evidence suggests that such patients do better with MAOls. Likewise, patients with depression and obsessive-compulsive disorder may be more resistant to treatment, even with SSRls (Hollander et al. 1991)... 

Aagaard J, Vestergaard P. Predictors of outcome prophylactic lithium treatment a 2-year prospective study. J Affect Disord 1990 18 259-266. 

In high-risk individuals and groups people with clinical evidence of macrovascular disease other than CHD, the Heart Protection Study (HPS) (II) with diabetes, the HPS and Collaborative Atorvastatin Diabetes Study (CARDS) (12) the elderly, Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) (13) or with hypertension, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) (14) and Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) (15). 

Whether the monitoring of endoxifen plasma concentrations in breast cancer patients would constitute a valid approach to optimize individual dosage and improve treatment efficacy is under scrutiny and remains to be demonstrated. In that purpose large prospective studies relating endoxifen plasma levels to clinical outcomes are as yet needed. In this perspective, it is critical to settle analytical and selectivity discrepancies between methods and laboratories and to ensure reproducible quantification results between laboratories. These concerted harmonization efforts can be carried out within the frame of an international external quality control program, which as yet, remains to be organized. 

Chen CY, Kumar RN, Feng YH, etal. Treatment outcomes in patients receiving conventional amphotericin B therapy a prospective multicentre study in Taiwan. J Antimicrob Chemother 2006 57 1181-8. 

Varicocele can result in pain and infertility, and either or both may be present in any patient. One important additional group of patients that has been studied in several prospective studies in Europe is adolescent boys. In most cases of adolescent varicocele, the diagnosis is made incidentally on routine physical examination. Pain and dysfunctional spermatogenesis with or without testicular atrophy is an unfortunately frequent outcome for these patients and many advocate preemptive treatment for them as well [18]. 

Hamilton M, White J Factors related to the outcome of depression treated with ECT. Journal of Mental Science 106 1031-1041, 1960 Hammarback S, Backstrom T Induced anovulation as treatment of premenstrual tension syndrome a double-bhnd crossover study with GnRH-agonist versus placebo. Acta Obstet Gynecol Scand 67 159-166, 1988 Hamon M Neuropharmacology of anxiety-perspectives and prospects. Trends Pharmacol Sci 15(2 36-39, 1994... 

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